Basic Information
| Provider Information | |||||||||
| NPI: | 1972116473 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROWE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | BRADLEY | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1991 FORDHAM DR STE 102 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283043774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104844653 | ||||||||
| FaxNumber: | 9104839256 | ||||||||
| Practice Location | |||||||||
| Address1: | 1438 HIGHWAY 16 W STE C | ||||||||
| Address2: | |||||||||
| City: | GRIFFIN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302232096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7702330350 | ||||||||
| FaxNumber: | 7702330370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2020 | ||||||||
| LastUpdateDate: | 04/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT014770 | GA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 5932 | OK | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | P-CP011266T | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.